Individual
RYAN T DE LA CRUZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
NMCB - 3 UNIT 25269 FPO AP 96601, PORT HUENEME, CA 96601
(805) 892-4924
Mailing address
NMCB - 3 UNIT 25269 FPO AP 96601, PORT HUENEME, CA 96601
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
03/12/2008
Last updated
03/12/2008
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